| NPI | 1083641609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 154160-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 154160-1) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-03-20 |