| NPI | 1891757399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-5216) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX K6398) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2019-10-28 |