| NPI | 1740248038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD042354L) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA06700400) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA06700400) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD042354L) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-05-06 |