| NPI | 1558441378 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: CT 031010) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 031010) | 
| Enumeration Date | 2006-10-16 | 
| Last Update Date | 2018-03-17 |