| NPI | 1356506463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: KY 46264) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2012-00548) |
| 207W00000X Ophthalmology (Licence: KY 46264) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2018-03-17 |