| NPI | 1114997418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: AZ 68744) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 32434) |
| 208D00000X General Practice (Licence: NE 23537) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-10-25 |