| NPI | 1265845804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NC 2018-00306) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259852) |
| 207W00000X Ophthalmology (Licence: NC 2018-00306) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2019-01-27 |