| NPI | 1003072018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: AZ 54397) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD34227) | 
| 207W00000X Ophthalmology (Licence: NY 273302-1) | |
| 207W00000X Ophthalmology (Licence: DE C10009377) | |
| 207W00000X Ophthalmology (Licence: PA MT192252) | |
| Enumeration Date | 2008-07-30 | 
| Last Update Date | 2018-06-01 |