| NPI | 1326034901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 29119) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01044404) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-07-08 |