| NPI | 1396714820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 174308-1) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 041999) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-10-16 |