| NPI | 1922051127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DE C1-0003332) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE CI0003332) |
| 207W00000X Ophthalmology (Licence: NJ MA51036) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-11-14 |