| NPI | 1548240740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: SC 24814) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101040315) |
| 207W00000X Ophthalmology (Licence: SC TL 24814) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-10-22 |