| NPI | 1306814686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA 36742) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: IA 36742) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2019-01-29 |