| NPI | 1255441952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61291718) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01047658A) |
| 207W00000X Ophthalmology (Licence: MD D70499) | |
| 207W00000X Ophthalmology (Licence: UT 1143296-1205) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-05-04 |