| NPI | 1578068623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U8405) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2022027053) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-08-13 |