| NPI | 1528264215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD433857) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA08472100) |
| 207W00000X Ophthalmology (Licence: NY 244576) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2019-08-14 |