| NPI | 1932218005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WI 51070) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 51070) | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2024-04-09 |