| NPI | 1265828289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS T-2928) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD.311946) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-11-22 |