| NPI | 1467621524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME132342) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD28098) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: AL MD28098) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME132342) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2018-04-27 |