| NPI | 1871603753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: KY 35089) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 35089) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-07-05 |