| NPI | 1356877781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 58778) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 287677) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-04-04 |