| NPI | 1356731343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME161520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 317724) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2023-04-18 |