| NPI | 1952677858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: GA 077817) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 077817) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2019-07-07 |