| NPI | 1629509682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: ID M-16268) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ID M-16268) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2022-08-04 |