| NPI | 1942220405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA03510400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G32910) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-03-06 |