| NPI | 1467482984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101236475) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01062263A) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-01-30 |