| NPI | 1417954819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX N0758) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX N0758) |
| 207WX0120X Ophthalmology Cornea and External Diseases Specialist (Licence: TX N0758) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2021-06-18 |