| NPI | 1043289085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 38698) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 193120) |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: NY 193120) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-01-24 |