| NPI | 1326428533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 302791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066242) |
| 207W00000X Ophthalmology (Licence: GA 82826) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2023-01-06 |