| NPI | 1568473619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME52960) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME00529620) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2024-06-13 |