| NPI | 1477529303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 228041) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WV 21168) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 228041) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-05-24 |