| NPI | 1891900189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 48044) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 57378) |
| 207W00000X Ophthalmology (Licence: IN 01074950A) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2015-06-11 |