| NPI | 1801892146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 31597) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 56089) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-12-03 |