| NPI | 1649477787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 58570) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX N9216) |
| 207W00000X Ophthalmology (Licence: NJ 25MA09407400) | |
| 207W00000X Ophthalmology (Licence: NY 254104) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 254104) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2023-07-06 |