| NPI | 1811488687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A196430) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 315554) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2024-10-25 |