| NPI | 1477825875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2018008051) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 27450) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2024-04-16 |