| NPI | 1053312959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 030822) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: GA 030822) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2018-08-13 |