| NPI | 1578652921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 253440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 253440) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 0253440) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-03-31 |