| NPI | 1942322409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX L9618) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2024-0410) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX L9618) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2024-0410) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2025-07-17 |