| NPI | 1093796864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX j7484) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX J7484) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2022-02-04 |