| NPI | 1639128689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: OH 35066075B) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 207W00000X) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-10-28 |