| NPI | 1013127075 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: OR MD29182) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO BB4745785) | 
| 207W00000X Ophthalmology (Licence: OR MD29182) | |
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2025-07-08 |