| NPI | 1912266404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-9627) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NC 2017-00305) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2017-05-04 |