| NPI | 1467891812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME138716) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME138716) |
| 207W00000X Ophthalmology (Licence: SC LL35687) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2025-03-27 |