| NPI | 1851740591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: CA A170928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10506) |
| 207W00000X Ophthalmology (Licence: IA R-10506) | |
| 207W00000X Ophthalmology (Licence: IA MD-47052) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2022-11-14 |