| NPI | 1316034259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AL 30073) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME 115584) |
| 207W00000X Ophthalmology (Licence: GA 068033) | |
| 207W00000X Ophthalmology (Licence: AL MD30073) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-06-07 |