| NPI | 1487097341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.133062) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 322817) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2026-02-24 |