| NPI | 1073548434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 202238-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 202238) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-01-23 |