| NPI | 1649624883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: SD 13306) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SD 13306) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NE 34817) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-10-22 |