| NPI | 1477180099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 33783) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD492781) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-08-17 |