| NPI | 1326249558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 166680) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 166680) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2018-01-20 |