| NPI | 1396710364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA MA56943) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 56943) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MA MA56943) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MA MA56943) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MA 569453) | |
| 208000000X Pediatrics (Licence: MA 56943) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-06-05 |