| NPI | 1386201549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: IA MD-55448) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 81576-20) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2025-08-07 |