| NPI | 1952789018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: RI MD17520) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 297639) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MA 278962) | |
| Enumeration Date | 2015-05-09 |
| Last Update Date | 2023-11-20 |