| NPI | 1588855639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME114146) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 68566) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME114146) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 68566) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-04-19 |