| NPI | 1841649357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35138792) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 53655) |
| 207W00000X Ophthalmology (Licence: IN 01083585A) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2020-05-17 |