| NPI | 1285677229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: GA 81762) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 81762) |
| 207W00000X Ophthalmology (Licence: FL ME-85745) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-04-02 |