| NPI | 1548249618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 26937) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35130815) |
| 207W00000X Ophthalmology (Licence: IN 01060284A) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2018-02-06 |