| NPI | 1649566290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA10169900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD454263) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MA10169900) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD454263) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2022-10-03 |