| NPI | 1497139075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-47449) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D87623) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: IA MD-47449) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2020-07-31 |