| NPI | 1770586752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0045260) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0004852) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DE C1-0004852) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0045260) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2026-07-16 |