| NPI | 1184691065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 219404) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 222888) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2018-10-05 |