| NPI | 1972508026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 6192) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 57317) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NH 6192) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MA 57317) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-08-11 |