| NPI | 1407477318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD489280) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 328173) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MA12660300) | |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2025-08-13 |