| NPI | 1265878466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0068259) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 288006) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2025-10-06 |