| NPI | 1164689535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: NJ 25MA10421400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A120927) |
| 207W00000X Ophthalmology (Licence: NY 249954-1) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2024-01-18 |