| NPI | 1437184298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 036088) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 200507-1) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2011-06-14 |