| NPI | 1457739443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD477319) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA11905700) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2025-07-14 |