| NPI | 1659330272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD27224) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000027224) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2016-05-03 |