| NPI | 1932494143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX Q8541) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E-10773) |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: AR E-10773) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2020-08-20 |