| NPI | 1558892125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2023-00619) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2023-00619) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-08-29 |