| NPI | 1871912204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-15161) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD37037) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-03-18 |