| NPI | 1518151877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PR 17036) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX N4065) |
| 207W00000X Ophthalmology (Licence: PR 17036) | |
| 207W00000X Ophthalmology (Licence: NY 313053) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 313053) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX N4065) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2025-02-16 |