| NPI | 1598813750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 076640) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 235346) |
| 207W00000X Ophthalmology (Licence: FL ME103168) | |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2024-02-04 |