| NPI | 1881637510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA05614400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD033871E) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-06-03 |