| NPI | 1043650575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: MN 61983) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL U03526) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2018-10-15 |