| NPI | 1073583902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 288686) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD044541E) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD044541E) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-08-09 |