| NPI | 1063467454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 058600) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 058600) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-01-28 |