| NPI | 1336171263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME13790) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0013790) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-03-23 |