| NPI | 1407934219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD-17715) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A66924) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-07-16 |