NPI | 1639112097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA04054400) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ ma40544) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2024-11-27 |