| NPI | 1134342439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 197574) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 050644) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-09-20 |