| NPI | 1467771675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: TN MD53144) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD53144) |
| 207W00000X Ophthalmology (Licence: PA MD451281) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2022-03-21 |