| NPI | 1770661571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 257034) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G64422) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-05-04 |