| NPI | 1538154117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 19430) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 39266) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-05-01 |