| NPI | 1023547395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-48245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10970) |
| 207W00000X Ophthalmology (Licence: IA R-10970) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: IA MD-48245) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2021-07-19 |