| NPI | 1528212750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 240762) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 245862) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2018-06-04 |