| NPI | 1467407130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD041818E) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: WV 31518) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2026-05-05 |