| NPI | 1073601274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: AZ 16920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 16920) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2017-12-28 |