| NPI | 1407037872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME113175) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.095080) |
| 207W00000X Ophthalmology (Licence: KY TP066) | |
| 207W00000X Ophthalmology (Licence: FL ME113175) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2021-07-14 |