| NPI | 1770927212 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 51662)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 32807)  | 
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: SC 51662)  | |
| Enumeration Date | 2013-04-27 | 
| Last Update Date | 2021-01-13 |