| NPI | 1003347428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA12411000) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD473726) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-12-17 |