| NPI | 1386841666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 1021731) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY A238244) |
| 207W00000X Ophthalmology (Licence: NY A238344) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2025-02-04 |