| NPI | 1457585853 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MN 72651) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA10238600) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2022-10-17 |