| NPI | 1548202534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 044280) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CT 044280) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-04-03 |