| NPI | 1508009754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 50062) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01078210A) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 50062) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2020-10-22 |