| NPI | 1376863662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N7466) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: TX N7466) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2017-07-12 |