| NPI | 1083096531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TN 68549) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 327757) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2024-06-17 |