| NPI | 1306813522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 38219) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 38219) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2018-02-19 |