| NPI | 1518992890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA022326) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 0907611) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2010-12-10 |