| NPI | 1679576961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: LA 204870) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 204870) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2018-04-06 |