| NPI | 1063294858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA LT000983) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA LT000983) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |