| NPI | 1992123376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 11197395-1205) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: UT 11197395-1205) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2019-03-26 |