| NPI | 1154716959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 291790) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35135581) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35135581) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-01-04 |