| NPI | 1902207459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 21279) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PR 21279) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2022-10-20 |