| NPI | 1912174897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI MD13846) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: RI MD13846) |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2023-11-20 |