| NPI | 1528066586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: CT 033694) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 033694) | 
| Enumeration Date | 2005-07-13 | 
| Last Update Date | 2021-03-29 |