| NPI | 1750647186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: MD D83188) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 283240) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2021-06-23 |