| NPI | 1841581790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-00694) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 279509-1) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2016-12-08 |