| NPI | 1871754846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 256133) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 256133-1) |
| 207W00000X Ophthalmology (Licence: PA MD445486) | |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2019-02-08 |