| NPI | 1396987954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 254227) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: NY 257227) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2023-09-15 |