| NPI | 1518316900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 304140) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 304140-01) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2024-10-29 |