| NPI | 1316128184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 065962) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 65962) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2019-03-08 |