| NPI | 1154313989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 49741) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01071067A) |
| 207W00000X Ophthalmology (Licence: GA 63927) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2018-02-08 |