| NPI | 1053410555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD-3744) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: HI 3744) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2017-01-13 |