| NPI | 1952740920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A134903) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 297434) |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2022-07-21 |