| NPI | 1306890785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 219927) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD028446E) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-08 |