| NPI | 1417177569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 253220) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD431478) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2021-10-08 |