| NPI | 1285889311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 49890) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY TP334) |
| 207W00000X Ophthalmology (Licence: KY 4196) | |
| 207W00000X Ophthalmology (Licence: TN MD49890) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2023-03-07 |