| NPI | 1619327236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 291105) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 303727) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2022-08-02 |