| NPI | 1306103577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 24997) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: IA MD-44380) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2024-05-30 |