| NPI | 1528422268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-00882) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2022-00882) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-06-21 |