| NPI | 1174937775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME133038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME133038) |
| 208600000X Surgery (Licence: FL ME133038) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-09-16 |