| NPI | 1801275185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA11761800) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: NJ 25MA11761800) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2024-08-02 |