| NPI | 1003298365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 298718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264247) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-10-12 |