| NPI | 1902249139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 76821) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 76821) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2023-07-18 |