| NPI | 1114001427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: FL ME99890) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME99890) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-03-27 |