| NPI | 1033572698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 15568) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: KY FL052) |
| 207W00000X Ophthalmology (Licence: FL ME172472) | |
| 207W00000X Ophthalmology (Licence: WI 86415) | |
| 207W00000X Ophthalmology (Licence: KY FL052) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2025-11-13 |