| NPI | 1700864089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M0722) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX M0722) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2020-08-25 |