| NPI | 1609282375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 50248) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-44964) |
| 207W00000X Ophthalmology (Licence: KY R3518) | |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: IA MD-44964) | |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: KY 50248) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2023-04-04 |