| NPI | 1326070020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301510750) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 166756) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 166756) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-04-19 |