| NPI | 1578361812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX 48656) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX 48656) |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-08-26 |