| NPI | 1922005883 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME71209) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0071209) | 
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL ME71209) | |
| Enumeration Date | 2005-07-06 | 
| Last Update Date | 2021-06-03 |