| NPI | 1003235185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 280901) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 278580) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 280901) | |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: NY 280901) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2023-01-10 |