| NPI | 1376697698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A121253) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01059689A) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2025-01-27 |