| NPI | 1679865950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A147199) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A147199) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2023-09-28 |