| NPI | 1326212960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD436258) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA09259400) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA09259400) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD436258) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2019-05-06 |