| NPI | 1891723920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD10582) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD10582) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-02-18 |