| NPI | 1356309546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD018669E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA39672) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-05-12 |