| NPI | 1831651868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: WI 84144-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 73841) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2024-09-10 |