| NPI | 1285741298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0039576) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 39576) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-03-22 |