| NPI | 1891361465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2025-01940) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NC 2025-01940) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2026-07-16 |