| NPI | 1194068445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 275883) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2017006917) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2021-10-08 |