| NPI | 1871908889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 72615) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD463923) |
| 207W00000X Ophthalmology (Licence: IN 11018097A) | |
| 207W00000X Ophthalmology (Licence: IA 47187) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2022-09-08 |