| NPI | 1043694557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC LL38455) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: SC 38455) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-06-17 |