| NPI | 1346462637 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MA08739100) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT187796) | 
| Enumeration Date | 2007-05-03 | 
| Last Update Date | 2025-08-14 |