| NPI | 1467404467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0058054) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-06-2154) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-11-03 |