| NPI | 1952806671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 191193) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 316990) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-10-03 |