| NPI | 1922087766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 150467) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 150467) |
| 174400000X Specialist (Licence: NY 150467-1) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2024-02-20 |