| NPI | 1295796498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX H5911) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX H5911) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2017-06-28 |