| NPI | 1306918669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 195706) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 195706) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-01-29 |