| NPI | 1295732063 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD-14966) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD14966) | 
| Enumeration Date | 2005-07-07 | 
| Last Update Date | 2023-03-07 |