| NPI | 1396859682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 266016) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 48791) |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NY 266016) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-07-06 |