| NPI | 1518384684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A139751) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD187259) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2019-04-26 |