| NPI | 1649289133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 230343) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 199885) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-08-24 |