| NPI | 1447299631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 231345) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA07734500) |
| 207W00000X Ophthalmology (Licence: FL ME95436) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-11-25 |