| NPI | 1023377306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 270631) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MA 270631) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2023-06-14 |