| NPI | 1588975346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2021010996) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2021010996) |
| 207W00000X Ophthalmology (Licence: NY 288286) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 288286) | |
| Enumeration Date | 2010-06-27 |
| Last Update Date | 2021-08-10 |