| NPI | 1073797809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 5484681) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01062307) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2012-06-26 |