| NPI | 1205940392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA08820200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 35877) |
| 207W00000X Ophthalmology (Licence: IL 036119682) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2017-03-08 |