| NPI | 1447331087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 240088) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 7604451-1205) |
| 207W00000X Ophthalmology (Licence: FL ME93051) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-09-13 |