| NPI | 1063563823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: ID M-10686) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ID M-10686) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2026-08-12 |