| NPI | 1558475582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P0362) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX P0362) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-11-27 |