| NPI | 1588160188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME168086) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 101374) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME168086) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 101374) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-08-21 |