| NPI | 1669441101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 227186) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX M1668) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2024-07-16 |