| NPI | 1235690264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX V9131) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V9131) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-10-07 |