| NPI | 1568648699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2016018569) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME172681) |
| 207W00000X Ophthalmology (Licence: MO 2016018569) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME172681) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2025-12-15 |