| NPI | 1902291859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 59087) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101266297) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-02-28 |