| NPI | 1851336846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME123332) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 259340) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-03-07 |