| NPI | 1457588402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 60463) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: WI 60463) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-07-21 |