| NPI | 1023441052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A170239) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 288979) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2023-08-16 |