| NPI | 1972709541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A108144) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI MDR-5293) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-05-10 |