| NPI | 1548311319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 283796) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 253704) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2019-01-28 |