| NPI | 1073572236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 207362-01) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 207362) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2023-09-19 |