| NPI | 1235660051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0095615) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA11117200) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-10-06 |