| NPI | 1568529105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 52668101205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00043978) |
| 207W00000X Ophthalmology (Licence: UT 52668101205) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-08-16 |