NPI | 1356753883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA10328400) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD464705) |
Enumeration Date | 2014-06-02 |
Last Update Date | 2018-07-31 |