| NPI | 1154988012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA12579100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A182125) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2025-08-22 |