| NPI | 1679718506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX P2345) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX P2345) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2023-07-27 |