| NPI | 1013280890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD451845) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA09522400) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2021-07-16 |