| NPI | 1659698967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 20018-02590) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 53018) |
| 207W00000X Ophthalmology (Licence: MS 23966) | |
| 207W00000X Ophthalmology (Licence: GA 072079) | |
| 207W00000X Ophthalmology (Licence: AR E-9417) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: AR E9417) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: SC MD81655) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MS 23966) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NC 2018-02590) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2022-03-01 |