| NPI | 1124524319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0071480) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME155316) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2023-07-25 |