| NPI | 1972814374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 50246) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01073604A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R72235) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2020-07-30 |