| NPI | 1235242124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 256631) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA ML20008129) |
| 207W00000X Ophthalmology (Licence: NY 256631) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-24 |