| NPI | 1376766816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101051247) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101051247) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-02-24 |