| NPI | 1407974561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MN 52517) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 52517) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-03-11 |