| NPI | 1427008465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301095622) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 209856) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-04-11 |