| NPI | 1982091401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD466779) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: PA MD466779) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2019-07-09 |