| NPI | 1013270164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U0675) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 251998) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: TX U0675) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-04-04 |