| NPI | 1952368920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A80309) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 226559-1) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-03-07 |