| NPI | 1306948344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME109015) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD422617) |
| 207W00000X Ophthalmology (Licence: IN 01064912A) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-04-05 |