| NPI | 1538587936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2024-00263) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME144114) |
| 207W00000X Ophthalmology (Licence: FL ME144114) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-07-01 |