| NPI | 1922012582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 9182832-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 9182832-1205) |
| 207W00000X Ophthalmology (Licence: IA 38883) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-05-03 |