| NPI | 1780146548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: TX V1166) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V1166) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-07-03 |