| NPI | 1528271087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 40922) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 40922) |
| 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: AZ 40922) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-08-09 |