NPI | 1962459420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 235067) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 227978) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2015-03-31 |