| NPI | 1902234172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME130196) |
| Additional Taxonomies | 174400000X Specialist |
| 207W00000X Ophthalmology (Licence: FL MFC1714) | |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: FL ME130196) | |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2018-04-27 |