| NPI | 1801032800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME MD18474) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD452568) |
| Enumeration Date | 2008-12-21 |
| Last Update Date | 2025-10-28 |