| NPI | 1962446690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ MA60199) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA06019900) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-04-05 |