| NPI | 1255607206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 288740) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: NY 288740) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2022-04-03 |