| NPI | 1548234313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NC 2009-00355) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2009-00355) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME100129) | |
| 207W00000X Ophthalmology (Licence: MN 46912) | |
| 207W00000X Ophthalmology (Licence: FL ME100129) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-11-11 |