| NPI | 1558518332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 243701-01) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 243701) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2021-09-10 |