| NPI | 1184184996 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.147794) | 
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: OH 35.147794) | 
| Enumeration Date | 2019-03-20 | 
| Last Update Date | 2024-07-18 |