| NPI | 1720138498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD472031) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA11043600) |
| 207W00000X Ophthalmology (Licence: DE C1-0025982) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD472031) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA11043600) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DE C1-0025982) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-07-24 |