| NPI | 1962407791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 13632) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR N7179) |
| 207W00000X Ophthalmology (Licence: MS 15012) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: AR N7179) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 15012) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 13632) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2017-04-26 |