| NPI | 1205154895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P9481) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX P4981) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2024-09-18 |