| NPI | 1851898381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MB11890500) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NJ 25MB11890500) |
| 207W00000X Ophthalmology (Licence: CT 71130) | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-09-20 |