| NPI | 1801271457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: TN 65273) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2019-00233) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2025-04-30 |