| NPI | 1205192135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.152105) |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: FL ME123089) |
| 207W00000X Ophthalmology (Licence: FL ME123089) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-01-02 |