| NPI | 1366521759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 207748) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G85428) |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2019-04-27 |