| NPI | 1821057233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 239925) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-08-3433-B) |
| 207W00000X Ophthalmology (Licence: NY 239925) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-04-29 |