| NPI | 1386020709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PR 19473) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S5724) |
| 208D00000X General Practice (Licence: PR 19473) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2023-08-10 |