| NPI | 1932103736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 30334) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01043469A) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2009-12-23 |