| NPI | 1518182526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E7805) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 14833) |
| 207W00000X Ophthalmology (Licence: AR 440096201) | |
| 207W00000X Ophthalmology (Licence: MI 4301093592) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2019-02-07 |