| NPI | 1225270226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD451600) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME115610) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2014-04-13 |