| NPI | 1013984681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 227900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 47874) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2019-04-27 |