| NPI | 1285607028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD021728E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA04916100) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-09-19 |