| NPI | 1083690226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 49842) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01059150A) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2025-02-26 |