| NPI | 1881915619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL OS13365) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL OS13365) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2022-05-27 |