| NPI | 1003372715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA12233100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 20737) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2024-05-03 |