| NPI | 1609883479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 60639) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 22323) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-02-12 |