| NPI | 1407996176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: NC 2016-00134) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME112787) |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME112787) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-11-10 |