| NPI | 1669655213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OR MD173218) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD173218) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2021-02-20 |