| NPI | 1467635862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101253723) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101253723) |
| 207W00000X Ophthalmology (Licence: WV 32386) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WV 32386) | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2025-06-12 |