| NPI | 1114656485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-15092)  | 
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AR E-15092)  | 
| Enumeration Date | 2022-06-09 | 
| Last Update Date | 2022-06-21 |