| NPI | 1184600157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME34419) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME34419) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-04-22 |