| NPI | 1942485842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: UT 9454371-8905) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 16046) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2019-12-03 |