| NPI | 1255391801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SD 4573) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: SD 4573) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-01-03 |