| NPI | 1053456509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA6441700) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NJ MA6441700) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-10-28 |