| NPI | 1063419810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 51424) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 51424) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-05-22 |