| NPI | 1962026385 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V1492) | 
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX V1492) | 
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TX V1492) | |
| Enumeration Date | 2020-06-01 | 
| Last Update Date | 2024-07-02 |