| NPI | 1124039656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: SC 40241) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0053701) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-11-01 |