| NPI | 1851310254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 73876) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 120632) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-12-18 |