| NPI | 1760481030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: NY 172831) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: NJ 25MA05776200) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2025-02-19 |