| NPI | 1154374973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01043767A) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.124274) |
| 207W00000X Ophthalmology (Licence: KY 41406) | |
| 207W00000X Ophthalmology (Licence: MI 4301111306) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-06-12 |