| NPI | 1588124028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD480960) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD480960) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-07-05 |