| NPI | 1780905737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2015-00366) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: SC MD81606) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2020-10-14 |