| NPI | 1225267867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME127520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2013009612) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2024-03-28 |