| NPI | 1801839287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 220170) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 239485-1) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-12-16 |