| NPI | 1508278268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61613322) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R3587) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: GA 89954) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2025-01-27 |