| NPI | 1588011142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: KY 53465) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10057674) |
| 207W00000X Ophthalmology (Licence: KY 53465) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-05-25 |