| NPI | 1588683015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: CO 42488) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 42488) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-03-28 |