| NPI | 1518910280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: FL ME88190) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME88190) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-07-14 |