| NPI | 1629049481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WI 43749-020) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD 60211097) |
| 207W00000X Ophthalmology (Licence: WI 43749-020) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2026-05-19 |