| NPI | 1144684671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 63569) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MO 2020016519) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-04-09 |