| NPI | 1992753545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA MD.019548) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 019548) |
| 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: LA 019548) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-04-27 |