| NPI | 1588664379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI DO01478) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 200408) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2025-09-18 |