| NPI | 1164611513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TN 51282) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 51282) |
| 207W00000X Ophthalmology (Licence: GA 060144) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2020-06-22 |