| NPI | 1831328053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 293837) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME DO2180) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2020-05-01 |