| NPI | 1295783611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ 25MA07555900)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 212284)  | 
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 212284)  | |
| Enumeration Date | 2006-05-05 | 
| Last Update Date | 2024-01-19 |