| NPI | 1013259167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OR DO186862) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR DO186862) |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OK 6124) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2020-09-18 |