| NPI | 1720645286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD480231) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: DE DR0026719) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0102923) | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2025-07-09 |