| NPI | 1851519318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM A-1439-08) |
| Additional Taxonomies | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: FL OS19414) |
| 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: TX T7469) | |
| 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: CO DR.0054870) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-02-02 |