| NPI | 1548218787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD426030) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE Cl-0008438) |
| 207W00000X Ophthalmology (Licence: NJ 25MA08241800) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2019-05-06 |