| NPI | 1326532110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A177538) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A177538) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2025-03-21 |