| NPI | 1588636807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CT 31640) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 031640) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2017-12-12 |