| NPI | 1760439699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA07524900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 215633) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-07-08 |