| NPI | 1467859314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 294878) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: VT 042.001463) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2021-12-10 |