| NPI | 1780654780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CT 15607) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 015607) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2017-06-21 |