| NPI | 1902210123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 278794) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MA 278794) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-03-26 |