| NPI | 1083713374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 246076) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-088411) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2009-04-27 |