| NPI | 1649947805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX 47984) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: SC 86673) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-08-16 |