| NPI | 1831240704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25 MA 08432000) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 233311) |
| 207W00000X Ophthalmology (Licence: PA MD433967) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2014-04-23 |