| NPI | 1598781395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35-060299) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-060299) |
| 207W00000X Ophthalmology (Licence: FL ME130276) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-01-09 |