| NPI | 1265995492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: DC MD500002813) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101281873) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2024-09-18 |