| NPI | 1437157799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD041715E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA05207200) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-06-19 |