| NPI | 1194221648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U4600) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U4600) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-04-28 |