| NPI | 1831394899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: NJ MAO8558900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 243156) |
| 207W00000X Ophthalmology (Licence: NJ 25MA70894) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2024-05-15 |