| NPI | 1033420260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 2769541) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD451301) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2017-05-02 |