| NPI | 1780995993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: UT 14063472-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-41651) |
| 207W00000X Ophthalmology (Licence: WA MD60625861) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2025-04-16 |