| NPI | 1275950115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A156391) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: CA A156391) |
| 207W00000X Ophthalmology (Licence: WA MD.MD.60820872) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2019-09-17 |