| NPI | 1477500866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA06500600) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 1940951) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2018-12-11 |