| NPI | 1720340136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME136532) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0056464) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME136532) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0056464) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-07-05 |