| NPI | 1780320648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD493678) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PA MD493678) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2026-08-07 |