| NPI | 1700413317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 327794) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA 20A19818) |
| 207W00000X Ophthalmology (Licence: CA 20A19818) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-05-06 |