| NPI | 1760445787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 97000580) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: NC 97000580) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-12-07 |