| NPI | 1740424563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 73205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2013006686) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2023-03-23 |