| NPI | 1871704007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 44829) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: AZ 44829) |
| 207W00000X Ophthalmology (Licence: MA 243144) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2023-06-15 |