| NPI | 1477844108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD451157) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD451157) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2022-10-31 |