| NPI | 1548225139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: MA 225169) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 225169) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-06-27 |