| NPI | 1275514358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME051224) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0015224) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2017-04-21 |