| NPI | 1679550297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ 25MA08673200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VT 042-0011003) |
| 207W00000X Ophthalmology (Licence: WA MD00042397) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA08673200) | |
| 207W00000X Ophthalmology (Licence: MA 237850) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2016-05-08 |