| NPI | 1396736617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 0030416) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: NC 0030416) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2022-04-20 |