| NPI | 1427686906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 042.0018755) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 338674-01) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-08-03 |