| NPI | 1033704358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY FL072) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA LT000931) |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL 32181) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: KY FL072) | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2023-06-20 |