| NPI | 1316338080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A181412) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A181412) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2025-07-01 |