| NPI | 1194253435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U8958) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: RI LP04222) |
| 207W00000X Ophthalmology (Licence: RI MD18406) | |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: TX U8958) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2024-02-27 |