| NPI | 1952664468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: UT 10343475-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 142145) |
| 208D00000X General Practice (Licence: MA 2252137) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2020-01-23 |