| NPI | 1245761972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME149383) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME149383) |
| 207W00000X Ophthalmology (Licence: TX U3452) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U3452) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2026-05-22 |