| NPI | 1891710851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME60065) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME60065) |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: FL ME60065) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: FL ME60065) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-06-12 |