| NPI | 1205815115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME107366) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000048004) |
| 207W00000X Ophthalmology (Licence: NC 26182) | |
| 207W00000X Ophthalmology (Licence: SC 16937) | |
| 207W00000X Ophthalmology (Licence: GA 78997) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2023-11-06 |