| NPI | 1851457444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME 118571) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A101208) |
| 207W00000X Ophthalmology (Licence: NY 257187) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2015-01-02 |