| NPI | 1578900205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A132436) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A132436) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2018-04-13 |