| NPI | 1275620353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G87847) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 197701) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2023-07-13 |