| NPI | 1154487775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00038833) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: WA MD00038833) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2023-08-16 |