| NPI | 1285680157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD-058636L) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA-64061) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-12-01 |