| NPI | 1528476389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 04-39850) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 258770) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2024-12-19 |