| NPI | 1417252776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA09481500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD451904) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2015-08-27 |