| NPI | 1275670291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101269475) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD-439428) |
| 207W00000X Ophthalmology (Licence: PA MD-439428) | |
| 207W00000X Ophthalmology (Licence: VA 0101269475) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2026-09-19 |