| NPI | 1093733156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA07620500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D64728) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-09-05 |