| NPI | 1609856426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD-21430) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR 176569) |
| 207W00000X Ophthalmology (Licence: CA C54832) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-10-21 |