| NPI | 1811586621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 92185) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 92185) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2022-08-19 |