| NPI | 1306075619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: TX S5581) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 077582) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2024-06-23 |