| NPI | 1295116242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 58966) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 26687) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-11-30 |