| NPI | 1508220252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MS 27509) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 60893) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-12-28 |