| NPI | 1982043626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 042.0014108) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL TRN# 19923) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: SC 35919) | |
| Enumeration Date | 2013-06-16 |
| Last Update Date | 2020-10-14 |