| NPI | 1982697033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 158997) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CT 031410) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA05393900) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2017-04-16 |