| NPI | 1073837787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX T9976) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME129277) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME129277) | |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: FL ME129277) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2024-11-26 |