| NPI | 1669852661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NC 2020-02125) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2020-02125) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2021-09-21 |