| NPI | 1346213907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA06655300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD052294L) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-10-11 |