| NPI | 1184659310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD425959) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA07892400) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-08-22 |