| NPI | 1568412823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: FL ME95649) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME 95649) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-10-06 |