| NPI | 1528122819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MA 238309) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 227749) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-04-22 |