| NPI | 1710060520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01024567A) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R4071) |
| 207W00000X Ophthalmology (Licence: GA 011329) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |