| NPI | 1013597947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL MFC1839) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL 1839) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-06-01 |