| NPI | 1982716031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 5117971-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 5117971-1205) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-06-24 |