| NPI | 1659328011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 222431) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD453593) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2026-09-02 |