| NPI | 1902859374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101222101) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101222101) |
| 207W00000X Ophthalmology (Licence: VA 0101222101) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NC 2005-01046) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-10-21 |