| NPI | 1679577324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD-37052) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 052293) |
| 207W00000X Ophthalmology (Licence: KY 35448) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2023-02-12 |