| NPI | 1417016312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 4394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4394) |
| 207W00000X Ophthalmology (Licence: NY 252363) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-05-26 |