| NPI | 1609220979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: AZ 61972) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S5564) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2021-09-20 |