| NPI | 1477690535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 30438) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: AZ 30438) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-07-06 |