| NPI | 1265813810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME140307) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME140307) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-07-13 |