| NPI | 1447465406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC MD32317) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 233555) |
| 207W00000X Ophthalmology (Licence: GA 61766) | |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2022-07-26 |