| NPI | 1265414213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OR MD21053) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD21053) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2021-02-20 |