| NPI | 1861804825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-31343) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA R-09976) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: IA MD-31343) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2018-06-24 |