| NPI | 1730182221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 47269) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01074215A) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-07-14 |