| NPI | 1265623649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: WI 52245) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 52245-020) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2024-04-09 |