| NPI | 1346403961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 66356) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 275254) |
| 207W00000X Ophthalmology (Licence: FL ME112267) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-02-01 |