| 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 |