| NPI | 1518165448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35-095322) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 247780) |
| 207W00000X Ophthalmology (Licence: OH 35.095322) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-03-25 |