| NPI | 1992265029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA12394800) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 1014974) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-11-05 |