| NPI | 1043288608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 46646) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 147515) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-11-27 |