| NPI | 1609853571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 162920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 162920) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2017-03-27 |