| NPI | 1114124575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01069717A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN11512) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-03-21 |