| NPI | 1861442717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C165665) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2013-0818) |
| 207W00000X Ophthalmology (Licence: FL ME132296) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-04-20 |