| NPI | 1427019207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: PA MD063273L) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD063273L) |
| 207W00000X Ophthalmology (Licence: NJ 25MA08145200) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ 25MA08145200) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-08-05 |