| NPI | 1649492554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 247466-1) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OS014046) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2016-06-29 |