| NPI | 1689938060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD56097) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS T-2550) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2020-06-25 |