| NPI | 1790714327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NC 2017-02076) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME97293) |
| 207W00000X Ophthalmology (Licence: OH 35081389P) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-06-21 |