| NPI | 1710113352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI MD-18295) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI MDR-5715) |
| 207W00000X Ophthalmology (Licence: FL TRN 15107) | |
| 207W00000X Ophthalmology (Licence: FL ME124928) | |
| 207W00000X Ophthalmology (Licence: CA A124892) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2022-01-07 |