| NPI | 1982915344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD176895) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 51281) |
| 207W00000X Ophthalmology (Licence: KS 9407515) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2020-07-13 |