| NPI | 1023490281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 332434) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 59378) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2025-12-31 |