| NPI | 1023404118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A181119) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 313898) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-08-11 |