| NPI | 1457988065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A189179) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: CA A189179) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-07-01 |