| NPI | 1407864663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 30007) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: NY 109129) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: NJ 30007) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-04-27 |