| NPI | 1508853474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: WI 19057-020) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 19057-020) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2019-03-05 |