| NPI | 1235115890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 026652) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 26652) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2026-04-30 |