| NPI | 1841288131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD0000028873) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 049535) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2017-02-27 |