| NPI | 1871029025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101275576) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO DR.0066177) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101275576) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-07-12 |