| NPI | 1700842267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX G3604) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX G3604) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2020-10-27 |