| NPI | 1295701985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 9380) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 013768) |
| 207W00000X Ophthalmology (Licence: MA 151126) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2008-04-22 |