| NPI | 1336643022 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 333921)  | 
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: IA MD-51035)  | 
| 207W00000X Ophthalmology (Licence: IA MD-51035)  | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 333921)  | |
| Enumeration Date | 2018-03-19 | 
| Last Update Date | 2025-09-08 |