| NPI | 1033115373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD24639) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 24639) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2014-08-11 |