NPI | 1669477485 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 38479) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ ma38479) |
Enumeration Date | 2005-06-17 |
Last Update Date | 2018-10-15 |