| NPI | 1518725480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL TRN39007) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL TRN39007) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |