| NPI | 1770514796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD51758) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 36703) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-03-18 |