| NPI | 1285258574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 85008-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-52802) |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: IA MD-52802) | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2025-08-04 |