| NPI | 1881852366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 266959) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A117305) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2012-10-29 |