| NPI | 1871912279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A171653) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NY 292616) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-12-03 |