| NPI | 1568468106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A62061) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A62061) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2018-04-03 |