| NPI | 1043219900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 131130) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1311301) |
| 207W00000X Ophthalmology (Licence: NY 131130) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NY 131130) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2016-04-29 |