| NPI | 1871024414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD MD210011599) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0097567) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101278318) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2026-10-08 |