| NPI | 1619947280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: SC 20313) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 20313) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-05-30 |