| NPI | 1982256558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OK 42480) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2021-03136) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2024-02-19 |