| NPI | 1154373322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME-82002) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME82002) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-03-14 |