| NPI | 1114157104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 050713) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CT 050713) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2019-01-24 |