| NPI | 1457845919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX V7614)  | 
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MA11711100)  | 
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD479761)  | |
| Enumeration Date | 2018-06-19 | 
| Last Update Date | 2025-07-02 |