| NPI | 1750325635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 66663) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.133787) |
| 207W00000X Ophthalmology (Licence: UT 162806154) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: CT 66663) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-10-13 |