| NPI | 1548229305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 29793) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 239443) |
| 207W00000X Ophthalmology (Licence: NC 2007-00829) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-04-01 |