| NPI | 1821551714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 30330) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 68334) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2026-03-12 |