| NPI | 1629046131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2817821) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 2817821) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-03-01 |