| NPI | 1922089655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 129274 1) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 125274) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2014-01-15 |