| NPI | 1790005064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-47258) |
| Additional Taxonomies | 207WX0120X Ophthalmology Cornea and External Diseases Specialist (Licence: IA MD-47258) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2020-09-16 |