| NPI | 1588013759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL MD.43949) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AL MD.43949) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-01-08 |