| NPI | 1558329847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 35196) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 35196) |
| 207W00000X Ophthalmology (Licence: PA MD424839) | |
| 207W00000X Ophthalmology (Licence: PA MT178614) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2026-04-27 |