| NPI | 1093705683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 231319) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 231319) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2019-03-22 |