| NPI | 1639137524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD428512) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0008603) |
| 207W00000X Ophthalmology (Licence: NJ 25MA08060600) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD428512) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MA08060600) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-11-04 |