| NPI | 1720084601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD23890) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 23890) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2020-05-19 |