| NPI | 1437318409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 15185) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME115147) |
| 207W00000X Ophthalmology (Licence: UT 11672709-1205) | |
| 207W00000X Ophthalmology (Licence: NC TBD) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2024-01-03 |