| NPI | 1306386578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 23754) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 322102) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PR 23754) | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2024-09-09 |