| NPI | 1104923937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 081139) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 81139) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-06-28 |