| NPI | 1932106440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD419115) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA07489100) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2007-10-22 |