| NPI | 1831286699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 14255370-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 14956) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 14956) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2026-09-02 |