| NPI | 1710989470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 145786) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 145786) |
| 207W00000X Ophthalmology (Licence: NJ AS9339587) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ AS9339587) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2024-04-09 |