| NPI | 1528052719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A93698) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2023-2550) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2023-2550) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2024-05-24 |