| NPI | 1639411887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: WV 26528) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME138104) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: FL ME138104) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-07-28 |