| NPI | 1861464323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 61715) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 278622-1) |
| 207W00000X Ophthalmology (Licence: IN 01054818A) | |
| 208D00000X General Practice (Licence: MD D85441) | |
| 207W00000X Ophthalmology (Licence: AK 5655) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2021-11-12 |