| NPI | 1881154987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61442740) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01089469A) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-02-06 |