| NPI | 1811975493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 116323) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA03332300) |
| 207W00000X Ophthalmology (Licence: CA G031724) | |
| 207W00000X Ophthalmology (Licence: IN 01028855A) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2013-04-12 |