| NPI | 1447275771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 0420010920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 231444) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |