| NPI | 1689061442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T2464) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD467583) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2023-12-01 |