| NPI | 1477737096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 94683) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA021193) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2012-08-24 |