| NPI | 1205256724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2020-01424) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2020-01424) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2024-12-13 |