NPI | 1114902681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 204008) |
Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: NY 204008) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2020-10-18 |