| NPI | 1932605250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA12176100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 291872) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-04-17 |