| NPI | 1881612059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-6764) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 39715) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-05-26 |