| NPI | 1386677797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 19091) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01050235A) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-05-26 |