| NPI | 1386601318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OK 25180) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 25180) |
| 207W00000X Ophthalmology (Licence: TN 37549) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-01-02 |