| NPI | 1649566977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: PR 19484) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PR 19484) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-08-04 |