| NPI | 1285291310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2025-0519) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WV 32700) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2025-06-11 |