NPI | 1548255631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA04065200) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD034605E) |
Enumeration Date | 2005-09-14 |
Last Update Date | 2012-03-22 |