| NPI | 1538362058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 247857) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 247857-1) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2023-04-04 |