| NPI | 1104310192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NE 35687) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 35687) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-01-18 |