| NPI | 1366485062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME34059) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME34059) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2025-10-14 |