| NPI | 1346349339 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA03831300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 38313) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-10-03 |