| NPI | 1053307272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 203254) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 203254) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-08-21 |