| NPI | 1699390773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.150019) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.150019) |
| 207R00000X Internal Medicine (Licence: PA MT219903) | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2024-06-25 |