| NPI | 1053684746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 56628) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 27520) |
| Enumeration Date | 2012-02-11 |
| Last Update Date | 2024-10-01 |