| NPI | 1366411233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: PA MD045344E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA05351700) |
| 207W00000X Ophthalmology (Licence: PA MD046344E) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-08-24 |