| NPI | 1437384062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA09288500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 264224-1) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2018-03-06 |