| NPI | 1851654867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN DO2931) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL1589) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2016-07-13 |