| NPI | 1134427636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A119766) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A119766) |
| 207W00000X Ophthalmology (Licence: MA 258307) | |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2018-03-06 |