| NPI | 1174529564 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: ME MD16442) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 016442) | 
| Enumeration Date | 2005-06-22 | 
| Last Update Date | 2023-10-12 |