| NPI | 1801003033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MB018172) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ MB018172) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |