| NPI | 1427408228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-01043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211057) |
| 207W00000X Ophthalmology (Licence: TN 60971) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: NC 2022-01043) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2022-07-15 |