| NPI | 1750760609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 31506) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01098174A) |
| 207W00000X Ophthalmology (Licence: KY 61493) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2026-02-24 |