| NPI | 1285604918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA03484500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD018714E) |
| 207W00000X Ophthalmology (Licence: CA G41784) | |
| 208600000X Surgery (Licence: NJ 25MA03484500) | |
| 208600000X Surgery (Licence: PA MD018714E) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2008-04-14 |