| NPI | 1093161655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: VA 0101271206) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: MN 67035) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2022-06-16 |