| NPI | 1174559660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME 64480) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME 64480) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2008-10-09 |