| NPI | 1346558392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA09823500) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA09823500) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2019-05-06 |