| NPI | 1104980382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD15506) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2008009375) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-10-05 |