| NPI | 1427290360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME127512) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 75932) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME127512) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 75932) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2023-04-20 |