| NPI | 1861495632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: KS 04-36190) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 18341) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-09-25 |