| NPI | 1548207426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME106130) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 227534) |
| 207W00000X Ophthalmology (Licence: TN MD0000040193) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-11-22 |