| NPI | 1760700355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA09562900) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA09562900) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2017-09-06 |