| NPI | 1033199450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 161412) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 161412) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2018-02-19 |