| NPI | 1548553431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME137441) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME137441) |
| 207W00000X Ophthalmology (Licence: CA A125917) | |
| 207W00000X Ophthalmology (Licence: SC MMD.40497) | |
| 207W00000X Ophthalmology (Licence: GA 077488) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2021-07-14 |