| NPI | 1548757149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA12559400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 321732) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA12559400) | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2025-03-28 |