| NPI | 1275860140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME147261) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0086844) |
| 207W00000X Ophthalmology (Licence: PA MD432369) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA md432369) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2021-03-03 |