| NPI | 1154703676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX S2049) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S2049) |
| Enumeration Date | 2015-06-20 |
| Last Update Date | 2024-04-10 |