| NPI | 1235682311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME151215) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL ME151215) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2023-08-08 |