| NPI | 1487654117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0075734) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME75734) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2023-04-20 |