| NPI | 1609459239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX V5114) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V5114) |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2025-10-07 |