| NPI | 1245385129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA08298900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 240726-1) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2012-02-13 |