| NPI | 1619181260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 43354) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 43354) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2026-01-30 |