| NPI | 1801866504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 101726) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA02742900) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2013-03-19 |