| NPI | 1619597994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.151017) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.151017) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2026-08-20 |