| NPI | 1982967949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA C209074) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME135518) |
| 207W00000X Ophthalmology (Licence: CA C209074) | |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2026-07-31 |