| NPI | 1669493342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301080629) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01062242A) |
| 207W00000X Ophthalmology (Licence: OH 35091217) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-01-17 |