| NPI | 1326215435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 15115) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 245924) |
| 207W00000X Ophthalmology (Licence: NJ 25MA08438700) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2013-05-07 |