| NPI | 1851304612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA07723300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD428610) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2017-11-07 |