| NPI | 1851300461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: AZ 35715)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 35715)  | 
| Enumeration Date | 2006-08-05 | 
| Last Update Date | 2017-12-28 |