| NPI | 1861468530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX H7332) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX H7332) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2026-05-01 |