| NPI | 1710905161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NJ 25MA06932200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ ma069322) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-04-06 |