| NPI | 1003018102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 233935) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A100203) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-04-16 |