| NPI | 1720320872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A134573) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 67335) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A134573) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-04-26 |