| NPI | 1174085054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MO 2024032562) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: KS 04-49827) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-12-06 |