| NPI | 1992189500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA11104200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD480594) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2024-11-13 |