| NPI | 1316929383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 20146) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 29056) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NE 20146) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: IA 29056) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2021-09-10 |