| NPI | 1720073950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 000005223) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 05207) |
| 207W00000X Ophthalmology (Licence: AR R-3844) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2012-09-21 |