| NPI | 1295184158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME149195) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME149195) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2026-04-20 |