| NPI | 1356551691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 20492) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS T-1953) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-07-21 |