| NPI | 1003233255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 72802-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2018-01265) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: WI 72802-20) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-02-23 |