| NPI | 1396832143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 103035) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 103035) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-08-11 |