| NPI | 1497166730 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: NY 294143) | 
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 294143) | 
| 207W00000X Ophthalmology (Licence: NY 294143) | |
| Enumeration Date | 2014-05-08 | 
| Last Update Date | 2020-02-14 |