| NPI | 1982652772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 9133) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PR 9133) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-11-16 |