| NPI | 1639233448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD-11913) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: HI MD-11913) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-06-26 |