| NPI | 1316280217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 306733) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA10368500) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2021-04-06 |