| NPI | 1609238880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T5887) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 35682) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-06-08 |