| NPI | 1588624357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD024271E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA04570600) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2007-07-09 |