| NPI | 1699265744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD225318) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD225318) |
| 207W00000X Ophthalmology (Licence: UT 12733169-1205) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2025-07-07 |