| NPI | 1306386578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 34954) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 322102) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2023-06-16 |