| NPI | 1770547077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL OS9285) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL OS9285) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-03-16 |