| NPI | 1114928843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA04620000) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ 25MA04620000) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-04-16 |