| NPI | 1699156950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: MS 27439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 209770) |
| 207W00000X Ophthalmology (Licence: OK 34523) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2020-07-02 |