| NPI | 1033474820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 283443) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 5315056243) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2018-04-27 |