| NPI | 1962990556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD489642) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA12679400) |
| 207W00000X Ophthalmology (Licence: DE C1-0028079) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA12679400) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DE C1-0028079) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD489642) | |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2025-08-26 |