NPI | 1457810376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25IA12852100) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25IA12852100) |
207WX0107X Ophthalmology, Retina Specialist (Licence: NY 319018) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2025-09-23 |