| NPI | 1598374506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: KY 56997) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX 207W00000X) |
| Enumeration Date | 2020-07-26 |
| Last Update Date | 2022-08-16 |