| NPI | 1720219454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: PA MD448446) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD448446) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2023-06-23 |