| NPI | 1841290657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0030868) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 30384) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME30868) | |
| 207W00000X Ophthalmology (Licence: GA 30384) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2023-09-25 |