| NPI | 1841256757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA03485700) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 34857) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-03-30 |