| NPI | 1609212844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 77997) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101264079) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2020-11-02 |