| NPI | 1568625192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 245591) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 245591) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-05-26 |