| NPI | 1497133615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 285137) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY AS7163304) |
| 207W00000X Ophthalmology (Licence: OH 34.013846) | |
| 207W00000X Ophthalmology (Licence: NJ 25MB11093500) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2023-03-29 |