| NPI | 1669826681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD472916) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2020-00372) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2021-08-11 |