| NPI | 1841251824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 54627) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 150108) |
| 207W00000X Ophthalmology (Licence: CT 045654) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2015-11-14 |