| NPI | 1881690956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA05957000) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD049688-L) |
| 207W00000X Ophthalmology (Licence: CA G073259) | |
| 207W00000X Ophthalmology (Licence: FL 61304) | |
| 207W00000X Ophthalmology (Licence: MD D43059) | |
| 207W00000X Ophthalmology (Licence: NY 178644) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2010-08-02 |