| NPI | 1811934060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 10143) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01042605A) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-12 |