| NPI | 1912362708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY P99482) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: NY 292143) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2019-01-17 |