| NPI | 1427056050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA05362500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA053625) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-10-30 |