| NPI | 1144225343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA OG711830) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA G71183) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2017-07-17 |