| NPI | 1093334021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.152428) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME167350) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: OH 35.152428) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-06-04 |