| NPI | 1275563652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: FL ME131627) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D64669) |
| 207W00000X Ophthalmology (Licence: FL ME131627) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME131627) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-07-11 |