| NPI | 1588019566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101271730) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101271730) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2021-08-04 |