| NPI | 1821675091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MN 81825) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A180147) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2026-10-13 |