| NPI | 1245203066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: NJ 25MA07110100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA07734200) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2017-08-04 |