| NPI | 1801968011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 20927) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-07-6780-P) |
| 207W00000X Ophthalmology (Licence: PA MD-071663-L) | |
| 207W00000X Ophthalmology (Licence: IN 01049615A) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2019-11-03 |