| NPI | 1891173225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MT MED-PHYS-LIC-81043) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MT MED-PHYS-LIC-81043) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2024-03-18 |