| NPI | 1043360704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 319167) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA09796800) |
| 207W00000X Ophthalmology (Licence: NJ 25MA09796800) | |
| 207W00000X Ophthalmology (Licence: NC 01046) | |
| 208600000X Surgery (Licence: PA MT188099) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-09-10 |