| NPI | 1467076679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ R78547) | 
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NY 328901) | 
| Enumeration Date | 2020-06-03 | 
| Last Update Date | 2025-10-07 |