| NPI | 1508840273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301077685) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MI 4901004141) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2018-06-11 |