| NPI | 1780948893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: CO 58524) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 0058524) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 58524) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2025-03-27 |