| NPI | 1124261375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA12100100) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD495480) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME124007) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA12100100) | |
| 207W00000X Ophthalmology (Licence: PA MD495480) | |
| 207W00000X Ophthalmology (Licence: FL ME124007) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2026-05-27 |