| NPI | 1871882449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX S5043) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2018-0528) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2018-0528) | |
| 207W00000X Ophthalmology (Licence: LA 301831) | |
| 207W00000X Ophthalmology (Licence: TX S5043) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-09-15 |