| NPI | 1528198124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 41481) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 41481) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-09 |