| NPI | 1811382120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology Cornea and External Diseases Specialist (Licence: MD D0090134) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A161279) |
| 207W00000X Ophthalmology (Licence: MD D0090134) | |
| 207W00000X Ophthalmology (Licence: DC MD048660) | |
| 207WX0120X Ophthalmology Cornea and External Diseases Specialist (Licence: DC MD048660) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-08-13 |