| NPI | 1861478562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.059837) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: OH 35.059837) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-12-20 |