| NPI | 1952552630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA CERETELLE Executive Director 800-331-6634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2019-05-06 |