| NPI | 1366444754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 198895) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 198895) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2021-11-27 |