| NPI | 1275022535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA11381500) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101281183) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-02-20 |