| NPI | 1679577191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 2210101) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 221010) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2016-11-17 |