| NPI | 1295955672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 21928) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 45774) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-11-02 |