| NPI | 1730689340 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A165520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 291480) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-06-20 |