| NPI | 1528062320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00028489) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: WA MD00028489) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-10-08 |