| NPI | 1447545421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 273946) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101258297) |
| 207W00000X Ophthalmology (Licence: MD D0079286) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2018-03-17 |