| NPI | 1306837281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0076850) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0057603) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME0076850) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2024-09-10 |