| NPI | 1699183376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 19136) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD466563) |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: PR 19136) | |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2020-07-21 |