| NPI | 1245935535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 3015589) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2023-00742) | 
| 207W00000X Ophthalmology (Licence: IN 01097152A) | |
| Enumeration Date | 2023-04-04 | 
| Last Update Date | 2025-06-30 |