| NPI | 1093789679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD025037E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA04991900) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-11-03 |