| NPI | 1144380452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA06346400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA M00576982) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2013-07-18 |